Functional exercise of upper limbs for post-open-chest patients Patients with lung cancer, esophageal cancer and mediastinal tumor who have indications for surgery, surgical resection is their main treatment. However, the incision of open thoracotomy is large and many muscles are cut off, including the trapezius, latissimus dorsi, serratus anterior, external abdominal oblique muscles and other muscles related to shoulder joint movement; the lax tissue between the subscapularis and the periosteum of the chest wall is separated during surgery, and the scapula is pulled with a retractor and the ribs are propped up with a spreader to expose the chest cavity for surgery, so that the normal blood vessels, nerves and muscle structures of the chest wall are damaged; in addition, patients are generally reluctant to perform functional exercises after surgery because of the serious incision pain. Therefore, some of the patients were not only unable to lift the upper limb on the operated side, but even had the phenomenon of shoulder droop on the affected side when they were discharged. If this continues, the upper limb on the operated side does not receive timely functional exercise for a long time, and some patients will have sequelae such as stiffness of the shoulder joint on the operated side, atrophy of the upper limb muscle groups and dysfunction after a period of time after surgery, which seriously affects the quality of life of patients. Yanfei Cao, Department of Thoracic Surgery, Shaanxi Provincial People’s Hospital The significance of early rehabilitation exercises: shoulder joint function plays an important role in the whole upper limb, and its loss of function will lead to 60% loss of upper limb function. The time required for complete healing of the stiffness formed in the shoulder joint by braking for 7d, l4d and 21d is 52d, 121d and 300d respectively. postoperative exercise of the function of the affected upper limb can promote the blood flow of the whole body and the local area, so that the lateral branch circulation can be established as soon as possible in the tissues damaged by surgery, which is conducive to the absorption and elimination of pathological products, thus reducing pain, accelerating the decreasing edema of the affected limb and the recovery of skin at the surgical site This will reduce pain, speed up the decreasing of edema and recovery of superficial sensation in the operated limb, significantly improve the function of the affected upper limb, restore the motor function of the shoulder joint as soon as possible, prevent the emergence of sequelae such as disuse muscle atrophy, joint ankylosis and scar adhesions, and help the patient recover the ability to take care of himself to the maximum extent. Thus, the early rehabilitation exercise plan for the function of the affected upper limb and its timely implementation are of great significance for patients with posterior lateral incision to recover the function of the affected upper limb as soon as possible. Implement progressive functional exercise of the affected upper extremity in the following ways: ① After awake after surgery, you can do five fingers flexion and extension and fist clenching exercise at the same time; ② Start to do elbow flexion and extension exercise on the first day after surgery: you can do some things within your ability, such as brushing teeth and washing face with the affected hand; holding bowls and cups; ③ Start to do combing movement with elbow elevation on the second day after surgery, keep natural posture and do not tilt the neck; ④ Start to do upper arm elevation exercise on the third day after surgery. To protect the wound from excessive stretching, take care to hold the affected elbow with the healthy hand and proceed slowly so as not to feel severe pain; ⑤ Start shoulder exercises on the 4th postoperative day, touch the contralateral ear with the assistance of the healthy hand, gradually leap the affected hand over the head and touch the contralateral ear; ⑥ Start comprehensive exercises on the 5th postoperative day, swinging the hands from side to side; alternately lifting both upper limbs; holding the ten fingers of both hands behind the head The amplitude gradually increased. Postoperative functional exercise of the affected upper limb must be understood and actively cooperated by the patient and family members; functional exercise should be gradual and should not be done in a hurry.